Medicare payments to providers available for first time

Ambulance companies take a big chunk of the payments made by Medicare, but the companies say they’re reimbursed by the federal insurer at a fraction of the costs of the services they provide.

In Michigan, 33,046 medical service providers received nearly $2.8 billion in 2012, according to records released by the Centers for Medicare and Medicaid Services. But on average, those providers receive about 36 cents from Medicare for every dollar they bill the federal health insurer.

News outlets have made those payments to providers available to consumers across the country. They can be searched online by amount, provider or service category.

The payments to 880,000 health providers across the country under Medicare Part B were made available by the federal government April 9 following a Freedom of Information request by the Wall Street Journal.

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Medicare Part B covers doctors’ services, outpatient care and medically-necessary services and equipment. Medicare Part A covers hospitalization and nursing home care.

In Michigan, 209 medical service providers collected more than $1 million in 2012.

Of those collecting more than $1 million, ambulance companies collected $120 million.

But unlike physicians, who can refuse to participate in insurance programs, even Medicare and Medicaid, ambulance companies don’t have a choice, says Bill Grubb, CEO of Star EMS, one of Oakland County’s larger ambulance companies.

Star collected $3.49 million in 2012, according to CMS. That worked out to $647 per person receiving services but only $32.70 per service provided. Star’s submitted claims to Medicare were $6.55 million.

Grubb echoes complaints of doctors that Medicare doesn’t always cover the costs of services provided. And he notes that ambulances companies don’t have a choice.

“The ambulance industry is unique because physicians can choose to participate in Medicare or Medicaid or any insurance program,” Grubb said. “For medicare and Medicaid, we don’t get a choice. Part of our licensure is ambulance companies must transport people without regard to ability to pay.”

About the Author

Charles Crumm covers politics for The Oakland Press. Read his Elections, Politics and Policy blog at http://oaklandmichiganpolitics.blogspot.com/. Reach the author at charlie.crumm@oakpress.com
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